Radiofrequency Ablation of Spinal Tumors

Radiofrequency Ablation of Spinal Tumors In the current atmosphere in clinical research, we must be extremely careful in applying results from experimental studies to humans. In the November 2000 issue of AJR , Dupuy et al. [1] described in vivo (animal) and ex vivo changes in temperature of the vertebra and its surrounding soft tissue caused by a radiofrequency electrode. I think this may contribute greatly to the treatment of those patients with vertebral tumors who have limited options. However, in this article, Dupuy et al. also described the application of the procedure to two clinical cases as a part of the experimental study, with no discussion on why or when this clinical application was chosen. In addition, I cannot find the inclusion or exclusion criteria that should be an important part of the method of clinical investigation, nor do I see any description of approval by the institutional review board or other authorities. In regard to the indications, I agree with the authors that the patient with metastasis (the first case) had limited treatment options and that this treatment helped improve the patient’s condition, but I do not think that the 14-year-old boy with osteoid osteoma (the second case) was a reasonably good candidate for an experimental treatment. The disease was benign, and there were other reasonable treatment options. The lesion, with no thick cortical rim on the side of the spinal canal, was located close to the nerve root and the cauda equina, which might have been easily damaged. I believe that application of experimental treatments to humans is better published separately from basic experimental studies (in vitro, ex vivo, or in vivo animal studies) in most cases because any flaws in basic experimental studies have a negative effect on the clinical application. I am hopeful that the omission in this article is only in the description, and not in the process, of investigation. Shigeru Ehara Iwate Medical University Morioka 020-8505, Japan